Successful adult vaccine drives must centre disability inclusion – Authors' reply
Authors: David B Agus, Aurelia Nguyen, John Bell
Journal: The Lancet (2023)

We thank Sara Rotenberg and Matthew Downer for their thoughtful Correspondence about the importance of disability inclusion in vaccination strategies. We appreciate their efforts to highlight this topic and agree with its importance. Preventive therapies can have different benefits in different populations, and ensuring their equitable distribution and use in those populations who would benefit most is crucial to their success for the whole population. The recommendations from Rotenberg and Downer are consistent with public health guidance on vaccines and medical care for people with disabilities, including the US Centers for Disease Control and Prevention's guidance for vaccination sites for vaccinating older adults and people with disabilities, and WHO's key actions and policy recommendations for addressing health inequities faced by people with disabilities.1Centers for Disease Control and PreventionGuidance for vaccinating older adults and people with disabilities at vaccination sites.https://www.cdc.gov/vaccines/covid-19/clinical-considerations/older-adults-and-disability.htmlDate: Aug 10, 2021Date accessed: March 28, 2023Google Scholar, 2WHOTechnical brief: addressing health inequities faced by persons with disabilities to advance universal health coverage.https://cdn.who.int/media/docs/default-source/universal-health-coverage/who-uhl-technical-brief-disability.pdf?sfvrsn=7e31cb97_3&download=trueDate: March 8, 2023Date accessed: March 28, 2023Google Scholar, 3WHOGlobal report on health equity for persons with disabilities: executive summary. World Health Organization, Geneva2022Google Scholar Their recommendations about the design of data systems to collect disability data are also consistent with previous findings that further quantitative and qualitative data and research are needed on vaccination in people with disabilities.4O'Neill J Newall F Antolovich G Lima S Danchin M Vaccination in people with disability: a review.Hum Vaccin Immunother. 2020; 16: 7-15Crossref PubMed Scopus (18) Google Scholar Recent innovation in the past several years, particularly of digital infrastructure, has the potential to contribute to strengthening inclusive adult vaccination systems.5The Global Health Security ConsortiumA vision for global health: the digital toolbox needed to deliver one shot.https://assets.ctfassets.net/75ila1cntaeh/3Ha8OUugohTodgSJ6yv5Tj/2a1f56f575c373b3016087b4f86c1bfa/GHSC_One_Shot__Digital_Tools__January_2023_0.pdfDate accessed: March 29, 2023Google Scholar Going forward, we recommend that research and health systems use evidence-based strategies and work with the populations that they aim to serve to maximise the benefit of population-health interventions. DBA is the paid Founding Director and Chief Executive Officer of the Ellison Institute for Transformative Medicine, a public good for-profit (the Institute comprises both a for-profit entity, whose profits will be reinvested into future public health and disease research, as well as a not-for-profit research foundation), which draws collaborators from across conventional health fields, as well as from a broad range of other disciplines to study disease and potential ways to prevent, detect, and treat the disease, and is a paid faculty member of the University of Southern California. JB is a paid faculty member of Oxford University, a paid Non-Executive Director of Oxford Science Enterprises, an independent investment company that has active investments in life sciences (novel platforms, technologies, and approaches advancing the discovery of new therapeutics and vaccines), health tech (medical devices, tools, digital diagnostics, AI-powered clinical imaging, virtual reality therapy, and solutions to improve health-care delivery), and deep tech (quantum computing and enabling technologies, fusion energy, industrial heat, novel computer hardware, electrified transportation, and solutions to tackle depleting food resources), and is a paid Chair of the Bill & Melinda Gates Foundation's Global Health Scientific Advisory Board. DBA and JB are non-paid Co-Chairs of the Global Health Security Consortium, a partnership to support and guide leaders on the global health security agenda. AN is a paid Special Adviser to Gavi, the Vaccine Alliance. We declare no other competing interests. COVID-19 and other adult vaccines can drive global disease preventionThe COVID-19 pandemic has led to a renewed recognition of the importance of disease prevention and public health globally. The progress in COVID-19 vaccine technology is a small portion of the pipeline of new vaccines and injectable therapies that could prevent leading causes of premature death and disability. This pipeline comes from decades of investment by governments and work by pharmaceutical companies, academic researchers, and new entrants in the field. The urgent need for new COVID-19 vaccines has also accelerated developments in this pipeline. Full-Text PDF Successful adult vaccine drives must centre disability inclusionThe promise of a vaccine-centred future discussed by David B Agus and colleagues presents an important opportunity for disability inclusion.1 Many novel vaccine candidates target diseases that disproportionately affect people with disabilities, including COVID-19, other respiratory illnesses, and various non-communicable diseases.2 The 10–20-year gap in life expectancy for people with disabilities makes improving inclusion in future public health systems essential.2 Full-Text PDF